Glucophage Side Effects

Glucophage with a brand name of metformin is an oral antidiabetic medication used to lower the blood sugar levels. Specifically, it is a biguanide medication used as a first line drug for type II diabetes mellitus. Glucophage is available in plain tablets aNd Glucophage XR or extended release tablets available in film coated preparations.

glucophage side effects

Uses and Advantages of Glucophage

Glucophage is indicated for the following conditions:

  • Type II diabetes
  • Gestational Diabetes
  • Prediabetes in obese and overweight individuals
  • Polycystic ovary syndrome with insulin resistance
  • Non-alcoholic fatty Liver disease with insulin resistance
  • Premature puberty with insulin resistance

One advantage of Glucophage is that it prevents the cardiovascular complications of diabetes because it also reduces the level of the bad cholesterol in the body, which is the low density lipoproteins and triglycerides. Glucophage is also not associated with weight gain. It may also reduce mortality in patients as compared to other antidiabetic drugs. Glucophage is one of the two oral antidiabetics included in the World Health Organization Essential Medicines.

The exact mechanism of Glucophage includes the suppression of glucose production in the liver, thereby preventing high blood sugar levels. Liver glucose production is known as gluconeogenesis.

Glucophage Side effects

When prescribed and taken appropriately, Glucophage only cause few Glucophage side effects. It also does not lead to serious Glucophage side effects.  Specific Glucophage side effects include:

1. Gastrointestinal Glucophage side effects


The gastrointestinal Glucophage side effects are due to the increase in the dosage of the drug as well as the initial intake of Glucophage. Diarrhea is the most common gastrointestinal Glucophage side effects, which can be reduced by starting Glucophage in lower doses and gradually increasing the dose. Prolonged and steady use of Glucophage usually reduces this gastrointestinal Glucophage side effect.

Abdominal Cramps

Abdominal cramps may also be experienced by patients.


Vomiting is another common gastrointestinal Glucophage side effect as a result of starting Glucophage therapy.


There may also be increased gas production associated with the absorption of Glucophage in the gut.

Vitamin B12 malabsorption

Vitamin B12 malabsorption may be associated with the prolonged use of Glucophage. In this regard, early screening for vitamin deficiency should be employed to prevent vitamin B12 deficiency states that may lead to problems such as pernicious anemia.

2. Hematologic Glucophage side effects


Anemia may result because of vitamin B12 overdose as a Glucophage side effect of prolonged drug use. This may be prevented by proving vitamin B12 supplements or discontinuing the drug.

3. Metabolic Glucophage side effects

Lactic acidosis

A serious complication of lactic acidosis may result from Glucophage overdose, but correct dosing of the drug may not produce significant risk for lactic acidosis. This Glucophage side effect may develop in patients who have co morbid conditions such as liver and kidney diseases because of reduced elimination of Glucophage in the blood leading to the utilization of proteins and fats for energy production. This effect may also be associated with the production of lactate in the intestines; however, appropriate use of Glucophage usually prevents this Glucophage side-effect. Lactic acidosis may result in symptoms such as abdominal pain, hypothermia, dyspnea, hypotension and slow heart rate.


Hypoglycemia is a rare Glucophage side effect as a result of taking too much Glucophage. Intake of Glucophage does not commonly produce hypoglycemia, but the presence of strenuous exercise, decreased food intake, pituitary insufficiency, adrenal insufficiency, and alcohol use may increase the risk for hypoglycemia.

Decreased Thyroid stimulating hormone levels

There were few cases of reduction in the TSH levels in patients with hypothyroidism.

Decreased testosterone levels

There may also be decreased production of testosterone levels among male patients taking Glucophage, but this tends to be rare and can be prevented by proper dosing of the drug.

4. Hepatic Glucophage side effects


Hepatitis was also seen in two cases of patients taking Glucophage. This effect may be due to the prolonged and high dose intake of metformin that may possibly affected the liver. Regular monitoring of the liver enzymes as well as checking for jaundice may be essential to early detect liver problems.

5. Hypersensitivity Glucophage side effects

Allergic reactions

Patients allergic to Glucophage may experience hypersensitivity reactions when the drug is taken. It may produce rashes, itching, difficulty of breathing and wheezing.

6. Other Glucophage side effects

Leukocystoclastic vasculitis

This Glucophage side effect has been documented in a single case of a patient taking Glucophage. The exact mechanism is still unknown and it may be caused by other co morbid conditions present in the patient.

Presence of distinct odor

Some patients have reported fish odor or fishy odor in Glucophage tablets. This may be reduced by taking Glucophage film coated tablets.

These Glucophage side effects tend to more uncommon compared to other oral antidiabetic agents. The advantages of Glucophage should be considered in weighing the risk and benefits of drug intake. Being a safe drug, patients need not to worry about Glucophage side effects because the appropriate and monitored use of the drug does not likely to cause Glucophage side effects.

In order to prevent Glucophage side effects and other drug side effects such as Inositol side effects, it is essential to adhere with the prescription of the doctor and report presence of any co morbid conditions and use of other drugs in order to prevent interactions.

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